Jessica Boberg Harris, CCC-SLP

Primary specialty

Respiratory/Developmental/Rehabilitative Specialist/TechnologistTaxonomy code 225500000X

License

SA7351 Issued in FL

Practice address

910 S Winterhawk Dr Unit 101
St Augustine, FL 32086-3870

Phone

(904) 217-7648

Fax

(352) 666-3232

NPI assigned

Aug 12, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bayonne Physical Therapy Inc

  • Physical Therapist
  • Naples, FL
  • NPI 1063443158
  NPD (past)
• Bayonne Physical Therapy Inc

  • Physical Therapist
  • Naples, FL
  • NPI 1710919584
  NPD (past)
• Tender Care Medical Services of St. Johns County, Inc.

  • Rehabilitation Clinic/Center
  • St Augustine, FL
  • NPI 1619249406
  NPD (past)
• Tender Care Medical Services of St. Johns County, Inc.

  • Medically Fragile Infants and Children Day Care
  • St Augustine, FL
  • NPI 1902178775
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1245486182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 S WINTERHAWK DR UNIT 101",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863870",
            "telephone_number": "904-217-7648",
            "fax_number": "352-666-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 S WINTERHAWK DR UNIT 101",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863870",
            "telephone_number": "904-217-7648",
            "fax_number": "352-666-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JESSICA",
        "middle_name": "BOBERG",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225500000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist",
            "state": "FL",
            "license": "SA7351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harmony Senior Services Inc.
• Erin Marie Harper
• Patricia Harrell
• Ebony Harris
• Jennifer Lynn Harris, CNA
• Julia Harris
• Kevin Lee Harris, RRT
• Patrick J Harris, D O
• Sandra R Harris, LMSW
• Alexa Faith Harrison, RBT

• Respiratory/Developmental/Rehabilitative Specialist/Technologist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Respiratory/Developmental/Rehabilitative Specialist/Technologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.